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Do not despair about severity—yet
  1. Mathias Barra1,
  2. Mari Broqvist2,
  3. Erik Gustavsson2,3,
  4. Martin Henriksson4,
  5. Niklas Juth5,
  6. Lars Sandman2,
  7. Carl Tollef Solberg6
  1. 1 HØKH - The Health Services Research Unit, Akershus Universitetssykehus HF, Lørenskog, Norway
  2. 2 Department of Medical and Health Sciences, The National Centre for Priorities in Health, Linköping University, Linköping, Sweden
  3. 3 Centre for Applied Ethics, Department of Culture and Communication, Linköping University, Linköping, Sweden
  4. 4 Center for Medical Technology Assessment, Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
  5. 5 Stockholm Centre of Healthcare Ethics, LIME, Karolinska Institute, Stockholm, Sweden
  6. 6 Department of Global Public Health and Primary Care, Universitetet i Bergen Det medisinsk-odontologiske fakultet, Bergen, Norway
  1. Correspondence to Dr Carl Tollef Solberg, Department of Global Public Health and Primary Care, Universitetet i Bergen Det medisinsk-odontologiske fakultet, Bergen 5020, Norway; carl.solberg{at}


In a recent extended essay, philosopher Daniel Hausman goes a long way towards dismissing severity as a morally relevant attribute in the context of priority setting in healthcare. In this response, we argue that although Hausman certainly points to real problems with how severity is often interpreted and operationalised within the priority setting context, the conclusion that severity does not contain plausible ethical content is too hasty. Rather than abandonment, our proposal is to take severity seriously by carefully mapping the possibly multiple underlying accounts to well-established ethical theories, in a way that is both morally defensible and aligned with the term’s colloquial uses.

  • allocation of health care resources
  • distributive justice
  • ethics
  • health economics
  • public health ethics

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  • Twitter @mathbarra; @SEVPRI1

  • Contributors MBa made the initial draft (in collaboration with CTS) and MBa managed the iteration of revisions by all authors, until all authors were satisfied with the final submitted manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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